Hewitt orders an Indian take-away

Greetings comrades, and good news from the Health Commissariat. Comrade Hewitt’s communication initiative has reduced the wage bill in hospitals throughout the country.

Meanwhile back at the coal face, Dr Crippen is struggling to get information from his hospital colleagues.

Ten weeks ago, he referred an elderly lady with a malignant feeling liver and deranged biochemistry to the gastroenterologists under the TWR. She has now been seen three times at the hospital and had a battery of doubtless appropriate investigations. She came in today to discuss her progress.

All that was in the notes was a letter relating to the original assessment done nine weeks ago. This was little more than a recital of the referral letter I wrote and a list of the proposed investigations. It has taken six weeks for the letter to get through. Why?

Because it has been typed in New Delhi.

The new hospital typing pool

There is still a dog turd under Dr Crippen’s desk, as described here. I put it there two years ago when the cleaning services were “outsourced.” Now the typing has been outsourced as well.

The relationship between family doctors and hospital doctors used to be dynamic and interactive. Letters went backwards and forwards in the internal post within forty eight hours. Hospital secretaries were not well paid, but they did a good job. As any good secretary should, they understood the foibles of their bosses, and they corrected their grammatical howlers. That no longer happens. Dr Crippen cannot fault the presentation of the Indian letters. But understandably the consultants’ howlers remain, and there are one of two more of distinctly Indian origin. Words, phrases and punctuation do not always survive the return trip to New Delhi.

This system is causing misunderstanding and delay. There are confidentiality issues. It is putting a group of valuable English employees out of work which, as described here, is upsetting the unions and it is putting an unnecessary communication barrier between doctors.

It has hard to believe the savings are great. The downside, however, is enormous and is measured in patient suffering.